Utilization Mgmt Psych Spec

This position is set at CeDAR, UCHealth’s award winning treatment center for adults, including professionals, with substance use disorders. CeDAR, the Center for Dependency, Addiction, and Rehabilitation, is a division of UCHealth serving patients in both inpatient and outpatient settings. The main CeDAR campus located on the UCHealth Anschutz academic medical center campus in Aurora, CO and we operate a small outpatient clinic in Boulder as well. It is our honor to educate the next generation of addiction professionals. Apply here to join the #1 ranked treatment center in Colorado by Newsweek in 2021!

For information on CeDAR, visit our website: Inpatient and Outpatient Addiction Treatment in Colorado | CeDAR (cedarcolorado.org)

Summary:

Facilitates reimbursement through certification and chart documentation. Conducts admission and continued stay reviews based on utilization review criteria. Clarifies diagnoses and medical necessity for continued stay.

Work Schedule: Full Time Days

Responsibilities:
Facilitates reimbursement through certification process. Conducts admission and continued stay reviews based on appropriate utilization review criteria. Obtains certifications for urgent and emergent admissions.

Follows and intervenes on open cases, including appeals of denials. Communicates case problems to appropriate level. Facilitates chart documentation. Assesses presence of Severity of Illness/Intensity of Service criteria. Collects data from medical records for quality monitoring, compliance audits, risk management, and clinical outcome reporting.

Participates with case manager and social worker in triad configuration. Refers cases to and consults with case managers and social workers. Refers to and consults with medical staff and other internal staff to facilitate documentation and assure timely discharge. Communicates denial case status to case manager, social worker and attending physician.

Facilitates billing. Communicates with third party payors. Enters authorization and days approved data into financial and clinical information systems to facilitate hospital billing.

Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.

Requirements:

• Minimum Required Education: High school diploma or GED.
• Preferred: Bachelor's degree in a relevant field.
  
• Required Licensure/Certification: None Required.
• Preferred: LPC, LCSW, LAC, CAC2-3, or eligible for these certifications.
• Minimum Experience: 2 years of direct experience in addictions or behavioral health environment. Experience working with behavioral health insurance authorizations and referrals.

The pay range for this position is: $21.49 - $27.94 / hour. Pay is dependent on applicant's relevant experience.

An annual bonus may be paid to eligible employees based upon organizational and individual performance.

UCHealth offers their employees a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical, dental and vision coverage; retirement plans; paid time off; employer-paid life and disability insurance with additional buy-up coverage options; tuition and continuing education reimbursement; and a full suite of voluntary benefits such as identity theft protection and pet insurance. Our employees and their family members have full access to our Employee Assistance Program, which includes up to 5 free counseling visits and work/life solutions, such as one free legal consultation. In addition, other emotional counseling support is available depending upon their need.

At UCHealth, we do things differently

We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado’s largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it’s a passion.

Going beyond quality requires the perfect balance of talent, integrity, drive and intellectual curiosity. We are looking for individuals who recognize, like us, that the world of medicine is ever-changing and are motivated to do what is right, not what is easy. We support creativity and curiosity so that each of us can find the extraordinary qualities within ourselves. At UCHealth, we’ll do everything in our power to make sure you grow and have a meaningful career. There’s no limits to your potential here.

Be Extraordinary. Join Us Today!

UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an affirmative action/equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual’s race, creed, color, religion, gender, national origin or ancestry, age, mental or physical disability, sexual orientation, gender identity, transgender status, genetic information or veteran status. UCHealth does not discriminate against any “qualified applicant with a disability” as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.